I am looking for advice on how to assist a client who is 73, has permanent residency and does not qualify for Medicare. Her income may put her over the limit for MH standard, and she is not disabled. Another health center’s CAC did a HIX application with her, and it is saying that she […]
Is it possible to get an extension on CommonHealth coverage while DES is reviewing a supplement? A client sent hers back in December (reported by her) and it is still not processed. My facility did not receive the request for records from them until April, so that seems like quite a long time between her […]
Hello Loopers! We know that many of you want to join the fight to protect Medicaid. It is “make or break” time in Congress to determine whether they will cut hundreds of billions of dollars from Medicaid, known as MassHealth in Massachusetts. The cuts they are proposing would rip away health care coverage from hundreds of […]
If a client has a private POS plan with out of network benefits, will MH secondary pick up the co-pays, co-insurance etc. for an out of network provider?
A CAC at my org. has said that she called MH to enroll a client in a plan after they had become unenrolled recently. MH rep told her that clients who have MH through DTA are not allowed to enroll in a plan, they just have MH standard. Or, she said that the client will […]
from April 11th until today there has been an oddly high number of our patients moving from careplus coverage to standard, and for some, it is unenrolling them from their plan. Is there an explanation for this? If it was just a few I wouldn’t mention it, but it has been about 20-30 people who […]
I have a member who is a QMB Member (Senior Buy In). She was going to get Cataract Surgery at a local eye center. She has BlueCross and Blue Shiled PPO and Senior Buy in second. The eye center wanted her to pay $150 copayment for EACH eye. She explained that she was a QMB […]
I have had 3 members turning 65 this year. When I update the application to reflect they have Medicare, it gives them MassHealth CommonHealth determination? I tell people to ignore it, because that is not a true determination. However, they still get letters stating so and think they qualify for MassHealth. Another member, I updated […]
I learned today from a member that she was unable to delete an income proof she had mistakenly uploaded under the Documents tab. She called the Health Connector to see if they could remove it for her and she was told that members used to be able to delete documents on their own accounts, but […]
Is there any word on when the plan enrollment system will actually be working? We have not had any changes successfully processed in over a month. We have also sent paper enrollment forms with no luck. I have now just spent over an hour on the phone with a member calling. When we finally get […]